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Tag Archives: NCCI
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What if the employee was high at the time of the injury?
I had a client recently tell me that he’d heard if the employee was found to have drugs in his system, workers’ comp would deny the claim.
Like a lot of stories in the insurance world, this isn’t black and white, and will also vary by state.
In Maryland, Injuries caused solely by intoxication or the effects of drugs not prescribed by a physician are not compensable. Now, injuries caused where the primary cause is intoxication or
the effects of drugs entitle Claimants only to medical benefits, unless the controlled dangerous substance was prescribed by a physician and the use was not excessive or abusive.
Imagine the difficulty in proving the level of intoxication, as well as the burden to show the drug intoxication was the sole cause of negligence. It can and has been done, but is difficult to prove.
Md. Lab. & Empl. Code Ann. §§ 9-506(b), 9-506(c). and Md.Lab & Empl. Code Ann. § 9-506(d).
Be on the lookout!
Have you ever noticed a scheduled credit on your policy? Ever wonder why it’s there?
Often times brokers are able to negotiate these on your behalf, but sometimes the scheduled credits are adjusted based on the experience MOD changes.
Picture this…
It’s 2017 and you’re at the last year of your debit experience MOD of a 1.25. Your current WC policy for that year has a scheduled credit of .80, easing some of the pain of your current debit MOD rating. Your renewal policy comes in for 2018 with a new MOD of .78 and low and behold your scheduled credit is now a scheduled debit of 1.10. What gives? Virtually all of the premium savings you were expecting is gone!
Injury Types- What is Permanent Partial?
When reviewing your loss runs or mod worksheet you’ll run into the codes or following descriptions. A quick overview of the common injury types are outlined below.
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Fatal—Death claims
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Permanent Total—Claimant expected to never be able to return work
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Permanent Partial—Claimant expected to return to work but with some permanent impairment or disfigurement
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Temporary Total—Claimant expected to recover fully
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Medical Only—No benefits for lost wages are expected to be paid
NCCI States, Monopolistic States, and Independent Bureau States
A quick graphic to highlight the rating bureau for each state. As you’ll see, most states follow the National Council of Compensation Insurance, or NCCI.
